Objective To investigate the current status of decisional conflict in anticoagulant therapy for patients with atrial fibrillation, and to analyze its influencing factors. Methods Totally 219 patients with atrial fibrillation were investigated by using the general information questionnaire, the knowledge questionnaire for atrial fibrillation, and the Decisional Conflict Scale. Results The total score of decisional conflict in patients with atrial fibrillation treated with anticoagulant therapy was (41.47±17.54); 33 (15.07%) patients did not have decisional conflict, 90 (41.10%) patients were in the middle level of decisional conflict, and 96 (43.83%) patients had higher level of decisional conflict and had delayed decisional conflict. Multiple linear regression analysis showed that age, gender, marital status, education levels, numbers of complications, and knowledge of disease were the influencing factors of decisional conflict in anticoagulant therapy （P<0.05, P<0.01）. Conclusion The level of decisional conflict in anticoagulant therapy in patients with atrial fibrillant is high, which can not be ignored. Decisional conflict is influenced by many factors. Medical staff should make personalized treatment decision aids based on the influencing factors to reduce the level of decisional conflict, improve doctor-patient relationship and enhance treatment satisfaction.